DEI Data System - State Government

Disability Employment Initiative Evaluation

Documents and Forms

Document Name Document Type
DEI Data System Data Elements.xlsx Other-Data Elements to be Collected
DEI_Training_Site_Visit__Interview_Logistics__Protocol_01-26-13_JV_Final.doc Site Visit Protocol IC Document

Information Collection (IC) Details

IC Title:	DEI Data System - State Government	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Data Elements to be Collected			DEI Data System Data Elements.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title: System of Records Notice, DOL/ETA-15	FR Citation: 67 FR 16898

Number of Respondents: 16	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	289,972	289,972
Annual IC Time Burden (Hours)	23,294	23,294
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Site Visit Protocol	DEI_Training_Site_Visit__Interview_Logistics__Protocol_01-26-13_JV_Final.doc	01/30/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.